JAVS Fall 2005

Membership Dues 0 Referred by--------------------------(Print name of AVS member.) 0 $42 Regular Membership 0 $47 Internationa l Membership 0 $2 1 Student Membership (Resid ing out ide the U.S.) 0 0 $30 In ternational Student Membershi)J $52 Joint AVS/Canadian Membership (Residing outside the U.S.) (includes bo1h JA VS and CVS newslelter) 0 $2 1 Emeri tus Membership* 0 $42 Institutional Membership * (those age 65-p/us who have been a regular member.for a minimum of8 year::.) 0 Group Membership Rates ([tve or more applications suhmilted together. no online registration) __$36 Regular Membership __ $ 18 Student Membership 0 Additional Gift Membership: I falfprice regular membership ($2 1), must be accompanied by your regular membership renewal. We IVi/1 acknowledge your g iji to the person you list he/ow: Fi rst Name Last Name-------------------- Company ------------------------------------------ Address_____________________________________________________ Ci~/Sta te/Zip or Postal Code___________________________________________ ~ Country___________________ Home Phone -------------------- Work Phone----------------- f-a x ---------------------- Email ___________________ Website--------------------- AVS Local Chapter Dues: Membership in A VS local chapters is optional and must be accompaniefl by members/rip in tire A VS National organization. Please check all!hal app~y. All dues sen/ with !his app/icalion payable 10 the AVS.

Arizona Viola Society 0 $ 10 Regular 0 $ 5 Student Central TX Viola Society 0 $ 10 Regular 0 $ 5 Student C hicago Viola Society

Minnesota Viola Society 0 $ 1-l Regu lar 0 $ 4 Student NC Viola Society 0 $20 Regular 0 $ 10 Student Northern CA Viola Society

Oregon Viola Society 0 $ 10 Regular 0 $ 5 Student Palmetto Viola Society (GA/NC/SC) 0 $ 10 Regular 0 $ 5 Student Rocky Mt. Viola Society 0 $ 15 Regular 0 $ 10 Student Seattle Viola Society

Southe rn CA Viola Society 0 $10 Regular 0 $ 5 St-udent Utah Viola Society 0 $10 Regular 0 $ 7 Senior 0 $ 5 Student Viola C lub of DC/MD & VA

0 $20 Regul ar 0 $10 Student Idaho Viola Society 0 $10 Regular 0 $ 5 Student Iowa Viola Society

0 $ 10 Regular 0 $ 5 St udent Ohio Viola Society

0 $ 10 Regular 0 $ 5 Student Virginia Viola Society

0 $10 Regular 0 $ 5 Student Oklahoma Viola Society

0 $ 15 Regula r 0 $ 5 Student

0 $ 10 Regular 0 $ 5 Student

0 $10 Regular 0 $ 5 Student

0 $10 Regular 0 $ 5 Student

Payment Enclosed

AVS National Dues

$ $ $ $ $

Chapter Dues

I wish to make a donation to the Primrose Memoria l Scholarship Fund*

I wish to make a dona tion to the AVS Endowment Fund*

TOTAL (*Donations lo !he AVS are tax-deduclihle as allowed hy law.) 0 Check or money order in U.S. funds payable to the American Vio la Society enclosed 0 MasterCa rd 0 Visa 0 American Express: Credit Ca rd # Expires_____ Name on Card -------------------- Send appliculion and paymen/ to: American Viola Society

14070 Proton Rd, Suite 100 Dallas, Texas 75244 USA

(972)233-91 07 ext. 204

Fax (972)490-42 19

Join online at www.americanviolasociety.org!